Do You Think It's A Good Idea To Anticipate Difficulty? - Pandemic Concerns

If you were presented with information which indicates that you / we are headed for difficult times, how would you deal with it? Would you change the station in your mind and move on to something else? Would you take it as a cue to "let the good times roll" and let what will happen happen? Would you "run for the hills?" Would you freeze in place?

How would you react if you saw the following statement? "The avian flu bears the potential for societal disruption of unprecedented proportion."

Or: "Some will say this discussion of the Avian Flu is an overreaction. Some may say 'did we cry wolf?' The reality is that if the H5N1 virus does not trigger pandemic flu, there will be another virus that will."

Or: "Susceptibility to the pandemic influenza virus will be universal."

Or: "The clinical disease attack rate will be 30% in the overall population during the pandemic. Illness will be highest among school-aged children (about 40%) and decline with age. Among working adults, an average of 20% will become ill during a community outbreak."

Or: "Key disease containment strategies include: isolation, quarantine, social distancing, closing places of assembly (e.g., voluntary or mandatory closure of public places including churches, schools, theaters and restaurants,) "snow days / weeks" or furloughing non-essential workers, and changes in movement patterns."

Or, how about this one: "We don't know the timing of the next pandemic, how severe it will be. We don't know what drugs will work. We don't have a vaccine. Yet we are telling everyone to prepare for a pandemic. It's tricky...This is scary and we don't know...That's the message."

What would you say if I said these things? Would you say that I was trying to scare people? Or that I was "stirring the pot" unnecessarily and irresponsibly? This goes back to the questions at the top of this posting - how do you react to hearing difficult information?

Well the fact is that I didn't make any of it up. It can all be found in two publications from the government. The first is from the Department of Homeland Security, dated 9/19/06, and the other just came out from the Centers for Disease Control, dated 2/1/07. The first is a guide for managing critical infrastructure and key resources in the country in times of a pandemic, and the other is a "community strategy for pandemic influenza mitigation."

Having a snow day or two sounds just fine doesn't it? Oh, but wait a minute, if this system were to be inaugurated, and your family is one of the ones which is isolated or placed in quarantine, then the kids won't be playing outside, most people won't be going to work outside the home, sending out for pizza will be a questionable option, and ice cream will run out fast.

Then you say to yourself: "well a few days will be manageable." Yes it would be, but what if the two days becomes two weeks...or longer? Now that starts to get your attention, doesn't it? At this point you're probably thinking this is just way too exaggerated.

You have to ask yourself what would trigger this, and why would "they" do something as radical as this? Actually that's where it really starts to get interesting. The reason for the isolation and containment strategies is to curtail the spread of an epidemic for which there are no known vaccines and no currently known medications to halt its spread.

Ok, let's stop right here. This is a speed bump, so slow down!

I'm going to continue with some other facts and thoughts and will not get into really nasty stuff, but, well, if you tend to let your imagination run away you may want to just slow down. Remember, we are talking about thinking about something that could happen and how to use that thinking to our advantage. (The experts, I believe, are saying that it will happen but the always present and complicating issue is that no one knows when it will happen - but they sure seem to be trying to get our attention.)

Ok, this is where we have some good news and bad news. The good news is that if a pandemic were to happen, and if these isolation procedures were initiated and followed (with appropriate community support in place for the myriad of complications which one would anticipate) then the death rate would be substantially reduced. However, (big sigh), and this is why these isolation practices are already in place as a plan, the trigger point which will be used to activate them, is called a category 2 (of 5) and that is established when there are 90,000 deaths from the pandemic (in a relatively short period of time.) Maybe to put this is a bit of perspective, do you remember a few months ago when the E-coli event took place. Do I have it correct, it was in the neighborhood of 10-20 deaths?

Good news - if initiated, the numbers change dramatically. Bad news - if not initiated, very messy.

Now we start to get down to it. If you "buy" the necessity for the government to publish these documents (remember the second one was just published 2 days ago) then how do you want to proceed? If your behavioral style is to slip into deny mode, is that how you want to process this information? Do you want to defer to the experts and wait for them to solve the problem; is that what you want to do here? Do you want to accelerate living and having fun as if there is no tomorrow, is that what you want to do? Do you want to get into a bunker mentality and start hoarding food, or moving as far away from population centers as possible?

As they say, it's a free country. No one is going to try to get you to do something in the direction of planning. But this may be one of those places where you may want to think about some more proactive approaches.

If you choose a proactive process, what would that start to look like? I'll offer a few thoughts.

To make the thoughts real (would it be appropriate to say more real since we are still talking hypothetically?) consider this: Under this scenario, whole communities will be hunkered down. In the script mentioned, up to two weeks was one of the benchmarks - but that was for the beginnings of a category 2 out of a possible 5. The clear statement is that it could be more than that.

Let's for now just keep the two week mark for our discussion.

• I should think there will be considerably more room in the cupboards by that time. So food will be one issue.
• Another issue will be that the intent of the isolation procedures is to slow down the spread of the virus. And by extension what they are saying is that they are trying to lower the death rate. But, if I understand this correctly, the number of people who will be suffering from the flu will be much, much greater than that. That's a lot of people sick with the flu. Do you remember the last time you were feeling really lousy with the flu, one with diarrhea and vomiting? Nasty wasn't it. So that will be a second class of issues to get our attention in terms of preparation.
• The third big issue that comes to my mind is the issues coming from social isolation and increased social proximity. What if you don't see your friends at work? What if you have to be with the people you live with all the time? How many high energy children do you have?

If you wish to, if you consider it important, then start to give some thought to this. In my next post I'll list some of my ideas on preparation and this will also take the next step in my previous posting about dealing with issues of psychological shock.

Addendum A: I'd like to add a word or two about fear and anxiety. Consider this: when we are kids we experience fear as a normal part of the world. We know that we don't control all that much and that uncertainty is simply a major part of the way that it is. We don't think that through as a child, but that's how I look at it.

As we get older, we start to anticipate events and outcomes based on past events and this is where, we could say, anxiety starts to come on the scene. Then we start to develop schemas and plans and tactics to control outcomes and events in order to feel the world is safer. To a large extent this is very helpful. However, when we unknowingly or unthinkingly presume that we are actually in control and that uncertainty has been removed, then when something with shock potential happens, we are overwhelmed and potentially immobilized.

At that point we experience a "double whammy." First we are shocked that this could happen. Then we are left with additional fear because all of our plans and presumed clever "supremacy" "don't amount to much more than nothin.' "

Does this mean that we shouldn't plan? To my way of experiencing, absolutely not! We have always been swimming in a world of uncertainty, it's just that we often try to pretend that it's more certain than not. Also, when it comes to taking steps based on anticipated "big things" it's best to stay focused on learning as much as we can and then taking small and simple steps and notice where they lead. I will rush no more - even in these massively uncertain times. Finally, with acceptance of uncertainty comes the potential bonus of unexpected potentialities.

Addendum B: I find the timing of the release of the "community strategy for pandemic influenza mitigation" curious. I notice that the report was released two days before my local newspapers carried a report of how the H5N1 virus was found on a farm run by Europe's biggest turkey producer in Great Britain. The report said that 2,500 birds were confirmed infected and died. As a precaution an additional 159,000 were destroyed. The newspaper report was dated 2/3/07 but the turkey deaths started on 2/1/07. Coincidence or not?

Addendum C: I have some additional thoughts on practical ways to boost your immune system and also whether radical isolation is the way to go for individuals, but more on all of these things in later postings.